The benefits of custom foot orthotics

By Tim Mulholland, Podiatrist

What would make a pair of orthotics worthwhile for you?

Getting through a run without your Achilles making you turn around? More comfortable days in your work shoes? Being able to walk further before that sore spot under your foot starts complaining?

Those are the benefits I'm interested in when I prescribe orthotics. First, I want to understand what's hurting and what you want to get back to. Then we can work out how an orthotic might help.

Less pain during the things you do every day

Someone with Achilles pain might be stiff and sore each morning, then find they can only run so far before it starts hurting again. They're keen to be active. They're getting sick of this.

By the time we discuss orthotics, we've already talked about that problem and what they want to get back to. I'll have assessed what's sore and what's being asked to do more work than it currently tolerates.

Then I can explain the prescription.

Muscles pull on your foot. Orthotics push on it. By deciding where to push and how hard, I can change the stress on the area we're trying to help recover.

With that Achilles, I might prescribe an orthotic to reduce peak stress on the tendon while we use exercises to increase its capacity. With pain under the forefoot, I might need to move pressure away from a particular sore spot. Same clinical questions, different prescription.

The benefit we're looking for is less pain when you put that plan into practice. We should be able to talk about it in terms you care about: how the mornings feel, how the walk to work goes, what happens when you run.

Help with recovery while you get on with your day

Getting stronger takes time. You've still got to get to work tomorrow.

This is one of the practical reasons I consider orthotics alongside exercise. While you're wearing them in the shoes we've agreed on, they're changing how force is applied to your foot with each step. We can use that to reduce demands on the sore area during the parts of your day that are difficult to avoid.

Your exercises have their own job: building the capacity to tolerate more. I want both parts of the plan moving you towards your goal.

If you come in asking for orthotics, we'll probably talk about exercises. If you come in asking for exercises, I'll consider whether orthotics would help with your recovery too. How quickly you want to get back to something, and what your life asks of you in the meantime, matter to that decision.

There's a useful bit of convenience here as well. Once we've fitted the device, you've got something you can use in the agreed shoes as you go about your day. The exercise programme still needs doing, but the orthotic doesn't require a separate session in your diary.

I've written more about how I combine these options in Do I Need Orthotics, Better Shoes, Or A Strength Plan?.

More comfort in the shoes you actually wear

Ever gone for a longer walk than expected in your work shoes? You know quite a lot about those shoes by the time you get home.

An orthotic can improve how your foot and shoe work together. To do that well, I need to see the shoes you walk, work and train in. The prescription has to fit into your life, including the space available inside your footwear.

For many active people, I'm looking for gentle nudges, spreading pressure over as much of the foot as the prescription allows. Where the device pushes and how much it gives under your weight are things I prescribe. The aim is something you notice when you step onto it and think, “Oh, that's different. That's nice.”

Some situations require more pressure in a particular area. That's why there isn't one answer to what every orthotic should feel like. I'll work out how much help we need from the device, then check it with you in your shoes.

If it's uncomfortable, tell me. We can review the pressure, the fit and the footwear. You shouldn't be left at home trying to work out whether you've bought the wrong thing.

A way back towards running and sport

Less pain is a welcome start. Getting back to the activity you've been missing is what we're working towards.

For a runner, that means building enough capacity to handle running again. An orthotic can help change the stresses that are limiting them while their exercise programme prepares them for more training.

As we increase activity, I want to know how the session went and how things felt afterwards. The following morning matters too. A run that felt good at the time, followed by a much worse morning, gives us something to adjust.

We build from what you can tolerate. That gives you a way to move forward without treating every good day as permission to catch up on all the training you've missed.

Your goal might be a longer run, getting through training or returning to your usual sport. The benefit of the orthotic should connect to that goal, alongside the strength and activity progression that gets you there.

If you've tried orthotics before

If a previous pair felt hard under your arch or never got comfortable, it's reasonable to wonder what would be different this time. Bring them in so I can understand what you tried and what happened.

I'll explain which tissue we're trying to help, where the device needs to push and how that fits with your exercises, shoes and goals. An explanation that stops at “you need arch support” leaves too much of that conversation unfinished.

You should understand what I'm recommending and how we'll review it before deciding whether to go ahead.

What about the cost?

You want to know what you're paying for and what you can expect from it. That's a sensible part of deciding whether orthotics belong in your plan.

I'll explain what I'm recommending and why. You can see Pride's current orthotic and consultation fees here, so you know what the devices and appointments cost before deciding.

I also back our Paris and Melbourne orthotics with a device-fee refund promise. If you're unhappy within 12 months of receiving them, we'll refund the device fee, no questions asked. Consultation, fitting and other treatment fees are excluded. The full terms are here.

I prescribe orthotics regularly. You might be trying them for the first time, or working up the confidence to try again. That promise gives you room to make the decision without having to arrive with the same confidence I have.

If sore feet are keeping you from something you want to do, come and have an assessment at Pride. Bring the shoes you wear, any orthotics you've already tried, and an idea of what you'd like to get back to.

That's where we'll start.

About the Author

Tim Mulholland is a podiatrist and founder of Pride Podiatry in Melbourne CBD. He works with people dealing with heel pain, running injuries, Achilles and forefoot pain, and orthotic therapy, with a practical focus on matching treatment to the loads people actually need to handle.

His approach is simple: reduce the irritating load, build capacity, and give people a plan they can use in real life, not just in the clinic room.